Individual
JACK PAUL MEZA LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
421 FAYETTEVILLE ST STE 1100, RALEIGH, NC 27601-3000
(877) 418-2978
(866) 500-2186
Mailing address
421 FAYETTEVILLE ST STE 1100, RALEIGH, NC 27601-3000
(877) 418-2978
(866) 500-2186
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-25285
NC
106S00000X
Behavior Technician
—
NC
Other
Enumeration date
09/16/2020
Last updated
10/25/2021
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